- The Washington Times - Tuesday, February 4, 2003

Mary Lynch of Annapolis has "the winter itch." Every year when the weather becomes cold, she suffers from extremely dry skin.
To combat the condition, Mrs. Lynch, 68, applies a prescription cream every day, and uses a humidifier and water softener to lessen the possible irritation to her skin. Also, since cotton is soft, most of her clothes are made from that fabric.
"I shower as quickly as I can," Mrs. Lynch says. "The doctor recommends showering every other day, but I can't quite live with that."
During the winter, skin faces many possible dilemmas. Cold weather can not only make it feel dry and itchy, but also can cause a number of other conditions. The key to treating the problems effectively is finding the products that best suit the individual's needs.
Dr. Lisa Kauffman, chief of dermatology at Georgetown University Hospital, cares for Mrs. Lynch, along with other patients who develop complications in the wintertime.
Since there is less humidity in the air during the colder months, Dr. Kauffman says skin has a tendency to become dry. When it lacks proper hydration, substances that wouldn't normally bother it can cause irritation.
"If you find that your hands are cracking, you need to put on hand cream every night," she says. "It works better if you can wear cotton gloves or mittens with the hand cream underneath."
Using a humidifier in the bedroom is a way to add moisture to the air, she says. Also, taking short, medium temperature showers with limited amounts of soap once a day is another strategy to avoid dry skin. Unscented soaps such as Dove, Tone and Caress are less likely to dry the skin.
A moisturizer also should be used after exiting the shower, Dr. Kauffman says. When applying cream, put it on in the direction the hair falls on the body, which is from the shoulder to the elbow and the thigh to the foot. She says rubbing back and forth can create hair bumps on the skin.
"Men are notoriously resistant for using a moisturizer," she says. "They think it's too feminine, but you need to use a moisturizer."
In the winter, cream-based moisturizers work better than lotions, ointments or oils because of their thickness. Although there are many on the market, some effective ones for the body include creams by Cutemol, Eucerin, Cetaphil and Lubriderm. To prevent clogged pores on the face, oil-free moisturizers should be used, such as products by Eucerin Q10, Neutrogena, Cetaphil and Aveeno.
Since dry skin also can trigger outbreaks of cold sores, moisturizing the lips is just as important as the body, Dr. Kauffman says. For the lips, Aquaphor, which lacks drying agents such as menthol or camphor that are used in many lip balms, is effective. Vaseline is another less expensive option.
Acne patients who suffer from dry skin have the added dilemma of balancing moisturizing products with the struggle for clear skin, says Dr. Jeffrey Weddington, a dermatologist at Kaiser Permanente in Northeast. While some areas of their faces may break out with sores, others probably will still be dry. He suggests using an acne soap on the face, such a gel-based bar from Neutrogena or Cetaphil. He also advises applying oil-free moisturizers in lighter amounts on the face and the body.
Dandruff also tends to occur more in the winter. For those people who suffer from an itchy scalp, over-the-counter shampoos with selenium sulfide or zinc parathion can be helpful, such as Polytar-ZNP Shampoo or Nizoral shampoo.
When dry skin is left unattended, it can bring about eczema, a skin condition that can affect all ages, Dr. Weddington says. While the severity of the disease varies, the skin is usually dry, hot and itchy in mild forms. In more severe forms, the skin can become broken, raw and bleeding. Although it can look unpleasant, eczema is not contagious. With treatment, the inflammation can be reduced, though the skin will always be sensitive and need extra care. Moisturizers such as Lac Hydrin or LactiCare usually are prescribed for the condition.
Psoriasis, a chronic skin disease that generally appears as patches of raised, red skin covered by a flaky white buildup, is another situation that can occur if dry skin is not treated. Since psoriasis has a genetic component, it also is not contagious. Along with dry skin, other triggers that may induce the syndrome include emotional stress, injury to the skin, infections and reactions to certain drugs. The knees, elbows, scalp, trunk and nails are the most common locations for the problem to occur.
"Products have to be adjusted depending on each individual patient," Dr. Weddington says. "One moisturizer isn't better than another, but you just have to find one that particularly addresses your concerns."
Extreme winter temperatures can also cause rosacea, which makes the face appear red and blushed, Dr. Weddington says. Other causes for the disease include food and emotional distress. Although rosacea cannot be cured, it can be controlled with various medicines. According to the National Rosacea Society in Barrington, Ill., the disease affects an estimated 14 million Americans, and most of them don't know they have it.
Raynaud's phenomenon is another disease that can worsen during cold weather, says Carolyn Weller, national director of education and research at the Scleroderma Foundation in Byfield, Mass. It is a disorder that affects the blood vessels in the fingers, toes, ears and nose in people with abnormal sensitivity to cold in their extremities. Mrs. Weller, a registered nurse, says about 5 percent to 10 percent of the general population in the United States suffer from the illness. The organization's Web site is www.scleroderma.org.
When an attack takes place, a person may experience three phases of skin color changes white, blue and red in the fingers or toes. Since cold temperatures can cause an episode, the disorder appears to be more common in people who live in more frigid climates. However, people with the disorder who live in milder climates may have attacks during colder seasons.
In some cases, patients can manage the disease by dressing appropriately. In severe cases with problematic sores, a calcium channel blocker is prescribed. It helps to keep the blood vessels dilated, Mrs. Weller says.
Although Raynaud's phenomenon can occur on its own, it also can be secondary to another condition, such as scleroderma or lupus, Mrs. Weller says. In the winter, scleroderma patients need to diligently moisturize their skin. The disease, a chronic autoimmune condition, usually causes thick, tight skin.
The complete symptoms of scleroderma range from mild to life-threatening. Along with the possible thickening of the external skin, the internal organs also may become fibrotic, Mrs. Weller says. Even though there is no cure for scleroderma, the symptoms can be treated independently.
"If you find out you have the disease, find a doctor with whom you feel comfortable," Mrs. Weller says. "Educate yourself about the disease."
Apart from avoiding the "winter itch" and other possible problems, people should take care of their skin to help it look younger in old age, says Dr. Syed Amiry, a cosmetic dermatologist who is opening his own practice in Reston on Monday.
As people age, the moisture in their skin evaporates quite a bit, he says. "The dryness in the skin promotes aging. It doesn't retain as much moisture, and the amount of oil it produces is much less than when we are younger. Taking care of your skin will give it a younger, healthy and vibrant look."

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